Article

A population perspective on diagnostic criteria for Parkinson's disease.

Department of Epidemiology & Biostatistics, Erasmus University Medical School, Rotterdam, the Netherlands.
Neurology (impact factor: 8.31). 06/1997; 48(5):1277-81. pp.1277-81
Source: PubMed

ABSTRACT For Parkinson's disease (PD), little is known about how the choice of diagnostic criteria affects research results. Using data on PD from three community studies (from Argentina, the Netherlands, Italy), we compared the impact on prevalence of several sets of diagnostic criteria. Each set was based on cardinal signs--resting tremor, bradykinesia, rigidity, impaired postural reflexes--and required that other parkinsonism be excluded. Some sets had additional requirements related to duration of symptoms, asymmetry of signs, or response to medication. In terms of prevalence, much lower estimates were associated with the requirements of asymmetry of signs and response to medication. The assessment of these clinical features may not be practical in community studies. Impaired postural reflexes, as a cardinal sign, seemed superfluous. For community studies of PD, we recommend the following diagnostic criteria: at least two of resting tremor, bradykinesia, or rigidity, in the absence of other apparent causes of parkinsonism.

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Keywords

apparent causes
 
asymmetry
 
cardinal sign
 
clinical features
 
community studies
 
diagnostic criteria
 
following diagnostic criteria
 
Impaired postural reflexes
 
lower estimates
 
medication
 
Netherlands
 
Parkinson's disease
 
PD
 
prevalence
 
research results
 
resting tremor
 
rigidity
 
sets
 
signs
 
symptoms